In this guide13 sections
Nasal polyps are soft, painless swellings that grow from the lining of the nose and sinuses. They are not tumours and they are not cancer — they are the end result of long-standing inflammation, and the tissue is essentially waterlogged mucosa hanging into the airway.
Two things are worth knowing before anything else on this page.
First, the side matters more than the size. Polyps on both sides are common and almost always benign inflammatory disease. A single polyp on one side only is a different proposition and needs imaging and biopsy, because a small number of one-sided growths turn out to be something other than a simple polyp. That distinction is covered in full below, and it is the most important thing here.
Second, polyps are a long-term inflammatory condition rather than a one-off problem to be removed. Surgery has a clear role, and it works. But polyps recur in a substantial proportion of people, and the commonest reason is stopping the steroid treatment once surgery has made breathing easy again. Anyone offering you surgery as a permanent cure is overstating it.
This guide covers what polyps are, how to tell whether you have them, when a polyp is a warning sign, what actually works, and where nasal surgery fits in. Where your blockage turns out not to be polyps, the likelier causes are enlarged turbinates, a deviated septum or nasal valve collapse.
What Are Nasal Polyps?
The lining of the nose and sinuses is normally thin. Where it is inflamed for months or years, it swells, fills with fluid and eventually prolapses into the nasal cavity as a smooth, pale, teardrop-shaped swelling. That is a polyp.
They are typically described as looking like peeled grapes — grey or pale yellow rather than pink, and translucent. They contain no nerve endings, which is why they are painless and why large polyps can develop without any discomfort at all.
The medical name for the condition is chronic rhinosinusitis with nasal polyps, often shortened to CRSwNP. That name matters, because it makes clear that the polyps are a manifestation of sinus inflammation rather than a disease in their own right — which is why treatment aimed only at removing them tends to disappoint.
Symptoms of Nasal Polyps
- Persistent blocked nose — usually both sides, constant rather than fluctuating, and unchanged by seasons or time of day.
- Reduced or absent sense of smell. Often the earliest symptom and the one people notice most. Taste follows, since most of what we call taste is smell.
- Runny nose or post-nasal drip, frequently thick and persistent.
- Facial pressure or fullness, particularly across the cheeks and forehead. Usually pressure rather than sharp pain.
- Recurrent sinus infections that keep coming back once antibiotics stop.
- Snoring, mouth breathing and disturbed sleep. See snoring and sleep apnoea.
- Nasal-sounding voice.
How can you tell if you have nasal polyps?
You usually cannot see them yourself. Polyps sit further back than a torch will reach, and what people mistake for a polyp at the front of the nose is more often a swollen turbinate — which is normal tissue and should not be removed.
The pattern that points to polyps is a constantly blocked nose on both sides combined with loss of smell. That combination is fairly specific. Blockage that swaps sides through the day is more likely turbinate-related; blockage on one side only is more likely septal or, occasionally, something needing investigation.
Diagnosis is made on nasal endoscopy, which takes a few minutes in clinic.
Why the Side Matters
This is the section most pages on nasal polyps leave out, and it is the reason this one exists.
Polyps on both sides (bilateral) are the common picture. They reflect generalised inflammation of the sinus lining and are benign. This accounts for the overwhelming majority of nasal polyps.
A polyp on one side only (unilateral) is treated differently. Inflammation does not usually restrict itself to one side, so a solitary one-sided growth raises the possibility that it is not a simple inflammatory polyp. The alternatives include inverted papilloma, a benign but locally destructive growth with a small risk of malignant change; antrochoanal polyp, a benign single polyp arising from the maxillary sinus, common in younger people; and, less commonly, sinonasal malignancy.
In children, a one-sided nasal mass should never be biopsied before imaging, because a small number are encephaloceles — brain tissue protruding through a skull-base defect. Biopsying one causes a serious complication.
Additional features that increase concern, on either side: repeated one-sided nosebleeds, facial numbness, double vision or eye swelling, loose teeth or palate change, and pain, which simple polyps do not cause.
What this means practically: a one-sided nasal mass is investigated with imaging and, where appropriate, biopsy. That is not alarmism, it is standard practice, and it is why “I think I have a polyp on one side” is a reason to be seen rather than to wait.
Causes and Associations
The underlying process is type 2 inflammation of the sinus lining. Why it starts in some people and not others is not fully understood, but the associations are well established.
- Asthma. Strongly linked in both directions — a substantial proportion of people with nasal polyps have asthma, and polyps are common in people with asthma. Treating polyps often improves asthma control, and it is worth telling your respiratory team if you develop them.
- Aspirin and NSAID sensitivity. The combination of nasal polyps, asthma and reactions to aspirin or ibuprofen is called Samter’s triad, or N-ERD. Polyps in this group tend to be more aggressive and recur more readily. If aspirin or ibuprofen gives you wheeze, chest tightness or nasal symptoms, say so — it changes management.
- Allergic rhinitis and allergic fungal sinusitis.
- Cystic fibrosis — the reason nasal polyps in a child always prompt a sweat test.
- Primary ciliary dyskinesia and other conditions affecting mucus clearance.
- Age and sex — more common over 40 and somewhat more common in men.
Polyps are not caused by diet, by dairy, or by anything you have done. They are also not contagious.
Diagnosis
Nasal endoscopy is the key test. A fine endoscope shows the polyps directly, how extensive they are, which side they arise from, and what else is contributing — polyps frequently coexist with septal deviation and turbinate enlargement, and correcting one while ignoring the others produces a partial result.
CT imaging maps the sinuses, shows how much disease is present, and is essential before surgery for navigation. It is also the first step where a unilateral mass is found. MRI is added where a unilateral growth needs further characterisation.
Allergy testing, aspirin sensitivity history and lung function are considered where relevant. In children, testing for cystic fibrosis is standard.
Treatment
Steroid sprays
First line, and they work — but only if used correctly and continuously. Two things undermine them constantly: stopping once symptoms improve, and poor technique. Aiming the spray straight up the nose deposits it on the septum where it does nothing except cause bleeding. It should be angled outward, toward the ear on the same side, with the opposite hand.
Given for months rather than weeks. Sprays reduce polyp size and slow regrowth; they will not dissolve large polyps.
Steroid drops
More potent and better delivered than sprays, given in a head-down position so the drops reach the upper nasal cavity where polyps arise. Used in courses rather than continuously.
Oral steroids
A short course produces dramatic shrinkage and often restores smell within days. The effect is temporary, and repeated courses carry real risks — bone density loss, diabetes, weight gain, avascular necrosis of the hip. They are used to gain control or before surgery, not as a maintenance strategy.
Saline irrigation
High-volume saline rinsing genuinely helps and is under-used. It clears mucus and inflammatory debris and improves the delivery of steroid to the lining. Best done before spray or drops, not after.
Surgery: FESS and polypectomy
Considered where medical treatment has been used properly and has not controlled symptoms.
Polypectomy removes the polyps themselves. Functional endoscopic sinus surgery (FESS) goes further — removing polyps and also opening the natural drainage pathways of the sinuses, so that mucus clears and so that steroid sprays and rinses can actually reach the lining they need to treat.
That second point is the one people miss. FESS does not replace medication; it makes medication work. Surgery followed by stopping treatment is the single commonest route to recurrence.
Performed under TIVA as a day case, entirely through the nostrils with no external cuts and no facial bruising. Image guidance is used where anatomy is complex or where there has been previous surgery.
Most people notice breathing improve within one to two weeks and smell over one to three months, sometimes longer. Return to desk work is usually within a week.
Risks are low but real: bleeding, infection, adhesions, changes in smell, and rarely injury to the eye socket or skull base, which is why imaging and image guidance matter.
Biologics
For severe recurrent polyps not controlled by surgery and steroids, biologic drugs such as dupilumab, omalizumab and mepolizumab target the underlying type 2 inflammation directly. They are highly effective in the right patients.
In the UK these are NICE-approved for severe CRSwNP with specific criteria and are delivered through specialist NHS services, usually jointly between ENT and respiratory. They are not a private cosmetic-sector treatment, and where you meet the criteria we will refer you rather than offer an alternative.
Can Nasal Polyps Be Cured?
Not permanently, and it is more useful to know that upfront.
Polyps are the visible part of a chronic inflammatory condition. They can be shrunk, removed, and kept away for years — but the underlying tendency remains, and recurrence rates after surgery are meaningful, higher in people with asthma and higher again in Samter’s triad.
What genuinely reduces recurrence: continuing steroid spray or drops indefinitely after surgery; regular saline irrigation; treating asthma and allergy properly; avoiding aspirin and NSAIDs if sensitive; and attending follow-up so early regrowth is caught while it is still treatable medically.
Framing this as a condition to manage rather than a lump to remove leads to better outcomes and fewer repeat operations.
Will nasal polyps go away on their own?
Very small polyps can shrink when the underlying inflammation settles — after allergy treatment, for example. Established polyps do not disappear without treatment, and they tend to enlarge slowly over years.
Can nasal polyps be dangerous?
Simple inflammatory polyps are not dangerous in the way people fear, and they do not become cancerous. Left untreated for a very long time, extensive polyps can widen the nose or affect the eye socket, but this is rare and slow.
The genuine concerns are different: a unilateral mass may not be a simple polyp, and polyps commonly worsen asthma and disturb sleep. Neither of those is an argument for panic; both are arguments for being assessed.
Can You Remove Nasal Polyps Yourself?
No, and please do not try.
The nasal lining has an exceptional blood supply, and pulling at tissue in the nose can cause bleeding that is difficult to stop outside hospital. Polyps also sit close to the eye socket and the base of the skull.
More importantly, you cannot know what you are pulling at. Turbinates — normal, functional tissue — are frequently mistaken for polyps, and removing turbinate tissue causes permanent problems including empty nose syndrome. A one-sided mass may be an inverted papilloma, and in children may be an encephalocele.
There is no home method, tool or remedy that removes a nasal polyp. Tea tree oil, apple cider vinegar, turmeric and similar preparations have no evidence and can irritate the lining, making things worse.
Saline rinsing is the one home measure genuinely worth doing.
Nasal Polyps on the NHS
Nasal polyps are a medical condition, so NHS assessment and treatment are available and this is a reasonable route for most people. Your GP can start steroid treatment and refer to ENT where symptoms persist, where there are red flags, or where surgery may be needed. Biologics are NHS-only in practice.
Waiting times for ENT and for surgery vary considerably by area. Private assessment is worth considering where you want to be seen quickly — particularly with a unilateral mass, where the priority is finding out what it is.
Cost
Cost depends on what is required: endoscopy and consultation, CT imaging, and whether treatment is medical or surgical. FESS cost varies with how many sinuses are involved, whether it is revision surgery, and whether septal or turbinate work is needed at the same time.
Your exact cost is confirmed in writing after in-person consultation. Finance is available through Chrysalis Finance, subject to status — see our finance options.
Nasal Polyps FAQs
How can you tell if you have nasal polyps?
The characteristic pattern is a constantly blocked nose on both sides together with reduced or absent sense of smell. You usually cannot see them yourself — what is visible at the front of the nose is more often a swollen turbinate. Nasal endoscopy confirms it in a few minutes.
What do nasal polyps look like?
Smooth, pale grey or yellowish, translucent teardrop-shaped swellings, often compared to peeled grapes. They contain no nerve endings, which is why they are painless.
Are nasal polyps cancer?
Simple inflammatory polyps are benign and do not turn into cancer. However, a growth on one side only may not be a simple polyp — inverted papilloma and, less commonly, sinonasal malignancy can look similar. Any unilateral nasal mass is investigated with imaging and usually biopsy.
Can nasal polyps kill you?
Inflammatory nasal polyps are not life-threatening. The concern with a one-sided mass is that it may be something other than a polyp, which is why it is investigated. Polyps can also worsen asthma and disturb sleep, both of which matter for health more broadly.
Will nasal polyps go away on their own?
Very small ones may shrink if the underlying inflammation settles. Established polyps do not resolve without treatment and tend to grow slowly over years.
Can nasal polyps be cured permanently?
No. They can be removed and controlled, often for years, but the underlying inflammatory tendency remains and recurrence is common — particularly in people with asthma or aspirin sensitivity. Ongoing steroid treatment after surgery is what keeps them away.
How do you shrink nasal polyps?
Steroid sprays used correctly and continuously, steroid drops for more resistant disease, and short courses of oral steroids where rapid control is needed. Saline irrigation improves how well the steroid works.
What is the best nasal spray for polyps?
The differences between steroid sprays matter far less than using one correctly and continuously. Technique is the usual problem — the spray should be angled outward toward the ear on the same side, using the opposite hand, not straight up the nose. Your GP or ENT surgeon will advise on which preparation suits you.
Can I remove nasal polyps myself?
No. The nasal lining bleeds heavily, polyps sit close to the eye socket and skull base, and normal turbinate tissue is frequently mistaken for a polyp — removing it causes permanent harm. There is no safe home method.
Do home remedies work for nasal polyps?
Saline rinsing genuinely helps. Tea tree oil, apple cider vinegar, turmeric and similar preparations have no evidence behind them and can irritate the nasal lining.
What is Samter’s triad?
The combination of nasal polyps, asthma and sensitivity to aspirin or other NSAIDs, also called N-ERD. Polyps in this group tend to be more extensive and to recur more readily, so identifying it changes management.
Are nasal polyps linked to asthma?
Strongly, in both directions. Many people with polyps have asthma and vice versa, because both are driven by the same type of inflammation. Treating polyps often improves asthma control.
Does surgery cure nasal polyps?
It relieves obstruction, restores smell in most cases and opens the sinuses so that medication can reach the lining. It does not cure the underlying inflammation, and stopping treatment after surgery is the commonest reason polyps come back.
What is the difference between polypectomy and FESS?
Polypectomy removes the polyps. FESS removes polyps and also opens the natural drainage pathways of the sinuses, which improves clearance and lets topical treatment reach the affected lining. FESS generally gives better long-term control.
How long does recovery from sinus surgery take?
Breathing usually improves within one to two weeks, with congestion and crusting during that period. Most people return to desk work within a week. Sense of smell improves over one to three months.
Can children get nasal polyps?
They are uncommon in children, and when they occur, testing for cystic fibrosis is standard. A one-sided nasal mass in a child must be imaged before any biopsy, because a small number are encephaloceles.
Nasal and Sinus Assessment at Centre for Surgery
Assessment is led by our ENT surgeon and rhinologist, and begins with endoscopy — because the first question is whether these are polyps at all, and the second is whether they are on one side or both.
We offer medical management, polypectomy and functional endoscopic sinus surgery. Where symptoms are controlled on spray and drops, we will say that surgery is not needed. Where a unilateral mass is found, imaging comes before anything else. And where disease is severe and recurrent enough to warrant biologic treatment, we will refer you into the NHS pathway that provides it rather than offer a lesser private alternative.
All surgery is performed by GMC-registered surgeons at our own day-surgery facility at 95–97 Baker Street, Marylebone. We are regulated by the Care Quality Commission and rated Good overall. We recommend a two-week cooling-off period before any surgery is booked.
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Address: 95–97 Baker Street, Marylebone, London W1U 6RN
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Related Reading
- Nasal turbinates: why they swell and how they are treated
- Nasal synechiae (nasal adhesions)
- What is a deviated septum?
- Septoplasty (deviated septum surgery)
- Turbinate reduction surgery
- Nasal valve collapse
- Snoring and sleep apnoea
- Can surgery affect smell or taste?
- Septorhinoplasty
- Nose shapes: the common types
